Depressive symptoms in users and non-users of depot medroxyprogesterone acetate

To evaluate the possible effects of depot medroxyprogesterone acetate (DMPA) injectable contraception on depressive smptoms, we conducted a population-based prospective study with women aged 18-39 years old enrolled at a health maintenance organization. At baseline, 183 women used DMPA and 274 were non-users. Data on deppresssive symptoms and on factors potentially related to DMPA use and depression were collected by questionnaire at 6-month intervals for up to 3 years. In multivariate longitudinal analysis, we found an increased likelihood of reporting depressive symptoms among continuous DMPA users (OR = 2.44; 95% CI = 1.00-2.07) and discontinuers (OR = 1.60; 95% CI = 1.03-2.48) when compared to non-users, Women who discontinued DMPA use had elevated depressive symptoms prior to discontinuation (OR = 2.30; 95% CI = 1.42-3.70) and immediately Following discontinuation (OR = 2.46: 95% CI = 1.46-4.14), and depressive symptoms subsided at subsequent visits relative to nonusers. Our prospective analyses found an association between DMPA use and depressive symptoms but further research is needed to determine whether the relationship is causal. CONTRACEPTION 2000;61:385-390 (C) 2000 Elsevier Science Inc. All rights reserved.